The silent burden: Perinatal mental health experiences and service access in the Limpopo Province, South Africa

Background: Mental Health Conditions (MHCs), particularly anxiety and depression, are among the most common complications of the perinatal period, affecting up to one in four women globally. When left unaddressed, these conditions can adversely affect maternal well-being and have implications for both maternal and child health. Despite their widespread impact, perinatal MHCs remain underrecognised and inadequately addressed, particularly in resource-constrained settings.
Aim: To explore perinatal women's experiences with mental health and access to related services in the Capricorn District Municipality, Limpopo Province.
Setting: The study was conducted at primary healthcare facilities in the Capricorn District Municipality, Limpopo Province.
Methods: A qualitative exploratory design was employed. Purposive sampling was used to recruit perinatal women receiving care at selected Health facilities. Data were collected through 11 individual semi-structured interviews and one dyadic interview involving 13 women aged 16–44 years. Interviews were conducted primarily in Sepedi and lasted approximately 20–45 minutes. Interviews were transcribed verbatim and analysed using reflexive thematic analysis, with ATLAS.ti 22 used for data management.
Results: Thematic analysis yielded three core themes:
 (1) Experiences, knowledge gaps, and coping in the perinatal mental health journey;
 (2) Barriers to mental health access; and
 (3) Desired support services for perinatal mental health. The first two themes are each supported by three sub-themes, while the third theme stands independently without sub-theme support.
Conclusion: The findings highlight the important role of primary healthcare facilities in addressing perinatal mental health needs. Strengthening mental health support within primary healthcare may improve maternal well-being and contribute to healthier families and communities. Policies aimed at ensuring equitable access to perinatal mental health services should be prioritised.
Contribution: This study provides context-specific evidence to inform policy and practice aimed at improving perinatal mental health services in Limpopo Province and similar resource-constrained settings.
Keywords: Access to care; Limpopo Province; Maternal health; Mental health literacy; Perinatal mental health.